The invention is in a therapy apparatus for the shock wave treatment of a patient.
A shock wave therapy apparatus is described in EP-A-0 265 741. It comprises at least one therapy head which comprises a shock wave generator, a coupling membrane on the patient side and arranged therebetween a receiving space for coupling fluid. To the receiving space there is connected a fluid circulation which apart from a circulatory pump comprises several valves and a bleeding means in order to keep the coupling fluid flowing through the receiving space in a controlled manner bubble-free also during the treatment. In order to ensure an adequate through-flow of the therapy head and to keep the coupling membrane always pressed tightly on the body of the patient to be treated, it is necessary for the coupling fluid to be circulated in the fluid circulation with an adequate pressure and in a sufficient quantity, for which the conduit cross sections of the circulation must be relatively large. This leads to the further disadvantage that the handling of the therapy head during the patient treatment is unwieldy and awkward on account of the relatively thick fluid conduits.
A further therapy apparatus is described in DE 197 18 511 A1. It comprises a therapy head essentially of the above mentioned type, which via an electronic conduit is connected to a supply and operation unit. The therapy head is a closed constructional unit and contains a coupling medium which cannot be changed in its quantity. In order to permit larger penetration depths of the therapy focus into the body of the patient, coupling attachments are allocated to the therapy head. Coupling attachments are loose parts and may be easily lost. Furthermore the field of application of this therapy head is limited by way of the external coupling attachments or coupling cushions, because the coupling membrane of the therapy head only permits a very small penetration depth of the therapy focus of the therapy head and because the external coupling cushions do not permit an infinitely adjustment of the therapy head. Furthermore the application of the therapy head is very awkward because the surgeon by way of the coupling cushion must gradually feel his way up to the location of therapy.
In DE 44 04 140 A1 there is described a further therapy apparatus. It serves the treatment of pain conditions and the influencing of vegetative nerve system and comprises a shock wave generator, a coupling membrane on the patient side, a receiving space with coupling fluid and a central locating device. The therapy head of the shock wave generator is located completely in the coupling fluid of the receiving space and therefore all around must be protected with respect to the coupling fluid, for which complicated sealings are required. Furthermore there is necessary a complicated adjusting mechanics in order to be able to adjust the therapy head to the region of therapy.
The object of the invention lies in improving a therapy apparatus of the initially cited type as a hand apparatus, such that whilst maintaining an optimal execution of treatment of a patient, during this treatment one may operate simply and comfortably.
The therapy apparatus of the invention for the shock wave treatment of a patient has a main housing with a shock wave generator operable via a supply tubing with energy conduits and with a coupling membrane and a space with a coupling fluid. The quantity of the coupling fluid in the receiving space for the purpose of adjusting the coupling membrane to the patient is controllable. The receiving space containing the coupling fluid communicates with a control space which is likewise filled with coupling fluid and which at least partly comprises a flexible wall region, and wherein the flexible wall region of the control space can be impinged with a gaseous control force.
With the solution according to the invention the convenience of the therapy apparatus is significantly increased since the flow cross section of the control conduit for reducing and enlarging the coupling fluid quantity in the receiving space of the shock wave generator may now be kept very small since it is only necessary to lead a gas medium being under pressure, for example pressurized air, through this conduit which impinges the control space of the therapy apparatus with a gaseous pressure force. By way of the pressure force of the gas medium the flexible wall of the control space may be suitably pressed together or expanded so that the coupling fluid located in this space is pressed into the receiving space of the shock wave generator or may flow back again out of this, in order to be able to apply the coupling membrane of the shock wave generator on the body of a patient in a manner which is correct for the therapy. Thus no relatively sluggishly flowing fluid quantities need to be led through the control conduit of the common supply tubing, but only relatively quickly flowing pressure gases, by which means the concerned pressurized gas control conduit has a considerably smaller diameter than a corresponding fluid conduit, with the result that the supply tubing also containing electrical conduits for the shock wave generator, in its outer diameter may be kept considerably smaller than previously, which considerably increases the handiness of the therapy head whilst maintaining an exact and large-surface positionability of the coupling membrane of the shock wave generator on the patient.
In a preferred embodiment of the therapy apparatus according to the invention the control space is provided as a separate space in a rigid connection housing fastening on the outside to the main housing of the apparatus and that on this housing there is connectable a pressurized air conduit. The main housing is advantageously provided with an elongate handle in which the connection housing is contained and to which there is connectable a supply tubing which contains the pressurized air conduit for the control space, furthermore the handle is provided with an operating keyboard for the operation of the shock wave generator. By way of this the handiness of the therapy apparatus is considerably increased.
In a further preferred embodiment of the therapy head according to the invention there is provided a probing rod, with two end abutments and with a probing tip of X-ray opaque material, which is coaxially movable along an axis running through the focus of the shock wave generator and which from outside the main housing projects into the receiving space, wherein the front end abutment for the distal positioning of the probing tip is arranged in the focus of the shock wave generator. This permits a quick treatment positioning of the therapy apparatus at locations of treatment which are located in the region of the patient close to the skin.
In a further preferred embodiment the probing rod for purposes of bleeding may be designed at least partly as a hollow rod which in the region of its probing tip comprises at least one air inlet opening and in its section located outside the main housing at least one closable outlet opening.
The various features of novelty which characterize the invention are pointed out with particularity in the claims appended to and forming a part of this specification. For a better understanding of the invention, its operating advantages and specific objects obtained by its use, reference should be had to the accompanying drawings and descriptive matter in which there is illustrated and described a preferred embodiment of the invention.